<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153909362
Report Date: 02/02/2023
Date Signed: 02/03/2023 10:45:38 AM


Document Has Been Signed on 02/03/2023 10:45 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:BENITEZ-LOPEZ, MARTHA FAMILY CHILD CAREFACILITY NUMBER:
153909362
ADMINISTRATOR:BENITEZ-LOPEZ, MARTHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 444-1199
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93304
CAPACITY:14CENSUS: 0DATE:
02/02/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:TIME COMPLETED:
12:15 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On February 2, 2023 Licensing Program Analyst (LPA) Kari McWilliams attempted to conduct an unannounced annual inspection. When LPA McWilliams arrived at the house a gentlemen answered the phone and stated that Licensee Martha Benitiez-Lopez is no longer the owner of the home and they received in the keys in December.

LPA McWilliams contacted Licensee Martha Benitez-Lopez who stated that she has sent in her change of location address application for her new address. Licensee also stated that she has called and reported the closure; which LPA McWilliams acknowledged that phone call was documented. Licensee also stated that she spoke to her previous LPA about the move and they sent her the change of location application; that conversation was not documented. LPA McWilliams will follow up and place this facility on inactive status.

There were no children present at this facility.
SUPERVISOR'S NAME: Luisa GavoutianTELEPHONE: (559) 650-7879
LICENSING EVALUATOR NAME: Kari McWilliamsTELEPHONE: (559) 341-4724
LICENSING EVALUATOR SIGNATURE:
DATE: 02/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/02/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1